Individual
ANNETTE L JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2550 UNIVERSITY AVE W, SUITE 435S, SAINT PAUL, MN 55114-1052
(651) 647-1900
Mailing address
2338 DOSWELL AVE, SAINT PAUL, MN 55108-1631
(651) 647-1900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11266
MN
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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